Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational study
Background Epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) therapy is the standard treatment for advanced non‐small cell lung cancer (NSCLC) harboring common EGFR mutations, such as exon 19 deletion or L858 point mutation. However, the effectiveness of EGFR‐TKIs for patients wi...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.13718 |
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| author | Masaki Kanazu Masahide Mori Madoka Kimura Kazumi Nishino Takayuki Shiroyama Izumi Nagatomo Shoichi Ihara Kiyoshi Komuta Hidekazu Suzuki Tomonori Hirashima Toru Kumagai Fumio Imamura |
| author_facet | Masaki Kanazu Masahide Mori Madoka Kimura Kazumi Nishino Takayuki Shiroyama Izumi Nagatomo Shoichi Ihara Kiyoshi Komuta Hidekazu Suzuki Tomonori Hirashima Toru Kumagai Fumio Imamura |
| author_sort | Masaki Kanazu |
| collection | DOAJ |
| description | Background Epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) therapy is the standard treatment for advanced non‐small cell lung cancer (NSCLC) harboring common EGFR mutations, such as exon 19 deletion or L858 point mutation. However, the effectiveness of EGFR‐TKIs for patients with uncommon EGFR mutations remains unclear. Methods We retrospectively surveyed a consecutive database of NSCLC patients with EGFR mutations at five participating institutions. Data from NSCLC patients with uncommon mutations (including single or compound mutations), who were treated with systemic therapy between May 2016 and October 2018, were collected and analyzed. Results A total of 23 of the 524 patients whose data were collected had uncommon EGFR mutations. Of these, 22 received EGFR‐TKIs (gefitinib = 6, erlotinib = 4, and afatinib = 12). Patients who received first EGFR‐TKIs had overall response and disease control rates of 59.1% and 81.8%, respectively. The median progression‐free survival (PFS) of patients with G719X mutation (n = 13, median PFS = 32.9 months) was favorable, compared with those of patients with L861Q mutation (n = 4, median PFS = 6.4 months) and compound mutations (n = 4, median PFS = 7.3 months). The PFS of patients who received first‐ and second‐generation EGFR‐TKIs was 14.0 months (n = 10) and 7.3 months (n = 12), respectively. The median cumulative duration of treatment (DOT) with EGFR‐TKIs was 30.4 months, which was longer than those of cytotoxic chemotherapy (median DOT = 10.7 months) or immune checkpoint inhibitors (median DOT = 6.6 months). Conclusions EGFR‐TKIs elicit favorable responses and contribute to long‐term disease control in NSCLC patients with uncommon EGFR mutations. Key points Significant findings of the study: Our results demonstrate that both first‐ and second‐generation EGFR‐TKIs elicit favorable responses in NSCLC patients with uncommon EGFR mutations. What this study adds This study revealed all clinical courses for NSCLC patients with uncommon EGFR mutations. In addition to EGFR‐TKIs, CCT and ICIs were found to contribute to long‐term disease control in this cohort. |
| format | Article |
| id | doaj-art-ba8798f5bda44beb8be82c20d8a738ee |
| institution | DOAJ |
| issn | 1759-7706 1759-7714 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj-art-ba8798f5bda44beb8be82c20d8a738ee2025-08-20T02:57:57ZengWileyThoracic Cancer1759-77061759-77142021-01-01121909610.1111/1759-7714.13718Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational studyMasaki Kanazu0Masahide Mori1Madoka Kimura2Kazumi Nishino3Takayuki Shiroyama4Izumi Nagatomo5Shoichi Ihara6Kiyoshi Komuta7Hidekazu Suzuki8Tomonori Hirashima9Toru Kumagai10Fumio Imamura11Department of Thoracic Oncology National Hospital Organization Osaka Toneyama Medical Center Toyonaka JapanDepartment of Thoracic Oncology National Hospital Organization Osaka Toneyama Medical Center Toyonaka JapanDepartment of Thoracic Oncology Osaka International Cancer Institute Osaka JapanDepartment of Thoracic Oncology Osaka International Cancer Institute Osaka JapanDepartment of Respiratory Medicine and Clinical Immunology Osaka University Graduate School of Medicine Suita JapanDepartment of Respiratory Medicine and Clinical Immunology Osaka University Graduate School of Medicine Suita JapanDepartment of Respiratory Medicine Osaka Police Hospital Osaka JapanDepartment of Respiratory Medicine Daini Osaka Police Hospital Osaka JapanDepartment of Thoracic Oncology Osaka Prefectural Hospital Organization Osaka Habikino Medical Center Habikino JapanDepartment of Thoracic Oncology Osaka Prefectural Hospital Organization Osaka Habikino Medical Center Habikino JapanDepartment of Thoracic Oncology Osaka International Cancer Institute Osaka JapanDepartment of Thoracic Oncology Osaka International Cancer Institute Osaka JapanBackground Epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) therapy is the standard treatment for advanced non‐small cell lung cancer (NSCLC) harboring common EGFR mutations, such as exon 19 deletion or L858 point mutation. However, the effectiveness of EGFR‐TKIs for patients with uncommon EGFR mutations remains unclear. Methods We retrospectively surveyed a consecutive database of NSCLC patients with EGFR mutations at five participating institutions. Data from NSCLC patients with uncommon mutations (including single or compound mutations), who were treated with systemic therapy between May 2016 and October 2018, were collected and analyzed. Results A total of 23 of the 524 patients whose data were collected had uncommon EGFR mutations. Of these, 22 received EGFR‐TKIs (gefitinib = 6, erlotinib = 4, and afatinib = 12). Patients who received first EGFR‐TKIs had overall response and disease control rates of 59.1% and 81.8%, respectively. The median progression‐free survival (PFS) of patients with G719X mutation (n = 13, median PFS = 32.9 months) was favorable, compared with those of patients with L861Q mutation (n = 4, median PFS = 6.4 months) and compound mutations (n = 4, median PFS = 7.3 months). The PFS of patients who received first‐ and second‐generation EGFR‐TKIs was 14.0 months (n = 10) and 7.3 months (n = 12), respectively. The median cumulative duration of treatment (DOT) with EGFR‐TKIs was 30.4 months, which was longer than those of cytotoxic chemotherapy (median DOT = 10.7 months) or immune checkpoint inhibitors (median DOT = 6.6 months). Conclusions EGFR‐TKIs elicit favorable responses and contribute to long‐term disease control in NSCLC patients with uncommon EGFR mutations. Key points Significant findings of the study: Our results demonstrate that both first‐ and second‐generation EGFR‐TKIs elicit favorable responses in NSCLC patients with uncommon EGFR mutations. What this study adds This study revealed all clinical courses for NSCLC patients with uncommon EGFR mutations. In addition to EGFR‐TKIs, CCT and ICIs were found to contribute to long‐term disease control in this cohort.https://doi.org/10.1111/1759-7714.13718Afatinibepidermal growth factor receptorerlotinibgefitinibuncommon mutation |
| spellingShingle | Masaki Kanazu Masahide Mori Madoka Kimura Kazumi Nishino Takayuki Shiroyama Izumi Nagatomo Shoichi Ihara Kiyoshi Komuta Hidekazu Suzuki Tomonori Hirashima Toru Kumagai Fumio Imamura Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational study Thoracic Cancer Afatinib epidermal growth factor receptor erlotinib gefitinib uncommon mutation |
| title | Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational study |
| title_full | Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational study |
| title_fullStr | Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational study |
| title_full_unstemmed | Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational study |
| title_short | Effectiveness of EGFR tyrosine kinase inhibitors in advanced non‐small cell lung cancer patients with uncommon EGFR mutations: A multicenter observational study |
| title_sort | effectiveness of egfr tyrosine kinase inhibitors in advanced non small cell lung cancer patients with uncommon egfr mutations a multicenter observational study |
| topic | Afatinib epidermal growth factor receptor erlotinib gefitinib uncommon mutation |
| url | https://doi.org/10.1111/1759-7714.13718 |
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